Friday, June 25, 2010

Capital Of Longevity










Last winter, the New York City Department of Health released figures that told a surprising story: New Yorkers are living longer than ever, and longer than most people in the country. A New Yorker born in 2004 can now expect to live 78.6 years, nine months longer than the average American will. What’s more, our life expectancy is increasing at a rate faster than that of most of the rest of the country. Since 1990, the average American has added only about two and a half years to his life, while we in New York have added 6.2 years to ours. In the year 2004 alone, our life expectancy shot up by five months—a stunning leap, because American life spans normally increase by only a month or two each year. When these figures came out, urban-health experts were impressed and slightly dazed. It turns out the conventional wisdom is wrong: The city, it seems, won’t kill you. Quite the opposite. Not only are we the safest big city in America, but we are, by this measure at least, the healthiest.

The “average life expectancy” of a city is a statistically curious number. It’s not really a prediction about how long you’re going to live. It’s an average of how long everyone here lives—and thus it forms a good barometer of the overall health of the city. In particular, a city’s average life span is sensitive to the rates at which people die too young. Since the average New York life expectancy is now 78.6 years, anytime someone dies younger than that, it drags the city’s overall average down slightly.
The math works like this. Imagine that one man dies of AIDS at age 25. Since he was statistically supposed to live to 78.6 years, he’s died about 50 years too early, so he shaves 50 years off the city’s overall pool of life. If one Wall Street guy collapses of a heart attack at age 65, he shaves only ten years off. You’d have to have five Wall Streeters die at that age to equal the impact of one AIDS victim. By the same logic, one infant’s dying during childbirth—77.8 years too early—is equal to ten people’s succumbing to lung cancer at age 70. It is a very weird form of horse trading. The more you’re able to prevent young people—folks in their twenties and thirties—from dying, the more rapidly you boost a city’s overall life expectancy.
And this is precisely what the city has done, through a combination of smart public policy and sheer luck. All the boons of the nineties—the aggressive policing, the dramatic drop in crime, the renaissance of the city’s parks and street life, the freakish infusion of boom-time wealth—played a part. Take the miraculous evaporation of the homicide rate. In 1990, a stunning 2,272 New Yorkers were murdered; in 2005, that number dropped to 579. Since a majority of those being killed were younger men, the reduced murder rate alone added tens of thousands of years to New York’s life-expectancy pool. Another big drop was in HIV mortality rates. In 1994, deaths from AIDS peaked at over 7,100, but the arrival of better drugs and health care began to whittle that number by 80 percent—so in 2005, only 1,419 died of AIDS. Again, the majority of the lives saved here were those of younger men, resulting in a disproportionately big upward leap in our city’s life span. In 1989, the infant-mortality rate was 13.3 babies per 1,000, and by 2004, it had been halved, to 6.1, both because medical treatment improved and because alcohol and drug addictions eased. To top it off, drug-related deaths, another arena with disproportionately younger victims, tapered off, too.
Homicide, AIDS, and drugs are characteristically New York ways to die young, of course, so it’s no surprise that when we sharply decreased the fatalities they caused, we caught up with the rest of the country. But here’s the thing: It’s not just that we’ve conquered these urban blights. Cancer and cardiac arrest are down, too. The number of people in the city dying from heart disease has dropped by a third in the last twenty years, and cancer rates have slid by nearly a fifth. And again in these cases, New York is getting healthier faster than the rest of the U.S.
In essence, there is a health gap emerging between our massive metropolis and the rest of the country—some X factor that’s improving our health in subtle, everyday ways. In fact, a back-of-the-envelope calculation shows that once you take out those uniquely New York ways to die—AIDS, homicide, etc.—we’ve still added at least 200,000 extra years onto the city’s life-expectancy tables since 1980, making crucial advances in the same health areas the rest of the country struggles with. Like many New Yorkers, I’d moved here with some trepidation—always figuring that the stress, pollution, and 60-hour workweeks would knock about five years off my life. I was wrong—precisely wrong. But where, exactly, is our excess life coming from? 



Clive Thompson
@ nymag.com

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